December 21, 2000 Research Update



James Bogash, D.C. Mesa, AZ
info@lifecarechiropractic.com
www.lifecarechiropractic.com

In children receiving antibiotics, does Lactobacillus reduce diarrhea?

I have heard unconfirmed rumours from a semi-retired nurse that giving probiotics along with antibiotics was the standard of care back in the early seventies. If this is true, I wonder why the practice was stopped. This nurse said that the GI side effects were never see during those times. I would have much less of a problem with antibiotic use is all prescriptions were followed up with a course of probiotics. We have all read about the tremendous impact probiotics have on balancing and even controlling the immune system. If we destroy this flora without replacing it, we set our systems up for problems. wjm — Vanderhoof et al. 173 (6): 397 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071193/

Civilization and the colon

This is actually a nice review article on the impact of colon health on systemic health, as well as some of the beliefs throughout history. The author does seem to place less credence on past beliefs than on recent studies suggesting that fiber does not prevent colon cancer. As I had mentioned in a previous update, I would like to see a study done on the flora of the patients in the colon cancer/fiber study. Healthy flora will act on dietary fiber to produce butyrate, which has been shown to help colonocytes differentiate properly. wjm — Whorton 173 (6): 424 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071203/

Immune Responses Heightened in Mice w/o Mitochondrial UCP

This is an incredible article and will have some ground shaking impacts on many researchers. As a background, uncoupling proteins (UCP) are present in mitochondria and, when present, basically allow energy to be burned off to produce heat. These UCPs are believed to be essential in maitaining weight–more UCP, more energy burned. UCPs have been a focus of some researchers as a cure for obesity. But here we have a study in mice that shows that mice w/o UCP (does not burn fat well and tends toward obesity) have an improved immune response. This is dangerous ground–many researchers are searching for a way to produce greater amounts of UCP, and yet, as we may see, this type of approach may have severe consequences on overall health.

Nat Genet 2000;26:387-388,435-438 Mice lacking the gene for uncoupling protein-2 (Ucp2), which uncouples mitochondrial respiration from energy production, are unexpectedly not obese but instead have an enhanced ability to fight infection, a multinational team of researchers reports in the December issue of Nature Genetics. To see if Ucp2 was involved in energy dissipation, as had been previously proposed, Dr. Daniel Ricquier from Centre National de la Recherche Scientifique in Meudon, France, and multicenter colleagues generated mice lacking Ucp2. However, the mice were not obese and had a normal response to cold exposure or a high fat diet. Since Ucp2 is also expressed at high levels in organs of the immune system, and mitochondrial uncoupling had been linked to production of reactive oxygen species (ROS), the researchers suspected that Ucp2 might affect ROS levels in macrophages. To test this idea, they infected the mice with Toxoplasma gondii, which killed! off the wild-type mice while the knockout mice survived the 80 days of the experiment. Knockout mice also had a 63% reduction in parasitic cysts and inflammation sites in the brain. Isolated macrophages from knockout mice also eliminated the parasite much more efficiently than macrophages from wild-type mice, confirming the role of macrophages in clearing infection. Macrophages from Ucp2-knockout mice also had an 80% greater ROS production than wild-type mice. “The ability of Ucp2-[knockout] mice to more efficiently resist and eliminate an infectious challenge such as T. gondii appears to be related to the greater capacity of macrophages to generate ROS,” Dr. Ricquier and colleagues conclude. They note that Ucp2-knockout macrophages also kill Salmonella typhimurium more efficiently than wild-type macrophages, and “may indicate a generally increased resistance to infectious agents.” In an interview with Reuters Health, study ! co-author, Dr. Sheila Collins, from Duke University in Durham, North Carolina, suggested that understanding more about the regulation of Ucp2 could make it possible to “tinker with it to either make an immune cell more active or less active in response to some stimulus.” However, heightened ROS production could also lead to degenerative diseases, she noted, although they have not allowed the mice to age enough to see any age-related problems yet. “It is well established that mitochondria are the main source of ROS, but the notion that the UCPs are involved in their regulation is relatively new,” Dr. Antonio J. Vidal-Puig, from the University of Cambridge in the UK, comments in an accompanying editorial. He notes that UCPs could also have tissue-specific metabolic functions besides preventing oxidative stress.

Supplement Makers: Prelim Injunction Against FDA in Folic Acid Suit

Issues like this are always tough for us “whole food” physicians. I firmly believe that whole foods are, almost invariably, better for prevention than their manufactured counterparts. I did not review the original research article that sparked this suit, but I would like to see what the source of “natural” folic acid was. In my opinion, fortified foods such as enriched wheat flour are not natural sources. Whole grains and green leafy vegetables are the best sources of folic acid. Regardless, this issue of natural vs synthetic is important and needs further evaluation.

(article) Dec 04 – Several dietary supplement makers have filed for a preliminary injunction that would bar the US Food and Drug Administration (FDA) from taking action against a labeling claim touting the superiority of synthetic folic acid over food folate. The plaintiffs, including the dietary supplement firms Pure Encapsulations and XCEL Medical Pharmacy, filed suit against the FDA in the US District Court for the District of Columbia in mid-November, seeking to force the agency to permit the claim. The preliminary injunction would prevent the FDA from taking action against companies making the claim while that case winds its way through the legal system. Represented by the Washington, DC-based law firm Emord & Associates, the plaintiffs are seeking the right to state on their product labeling that “0.8 mg of folic acid in a dietary supplement is more effective in reducing the risk of neural tube defect! s than a lower amount in foods in common form.” A spokesperson for the March of Dimes, the non-profit organization devoted to preventing birth defects, said that the group recommends that women of childbearing age take 400 mcg, or 0.4 mg, of synthetic folic acid a day rather than relying on dietary folate. The recommendation is based in part on a recent report from the National Academy of Sciences’ Institute of Medicine stating that the synthetic folic acid found in supplements is preferable to food folate for preventing birth defects, she said. However, she stressed that taking synthetic folic acid should be “part of a three-pronged strategy” for women who may become pregnant, “which also includes eating foods fortified with folic acid and foods that are naturally rich in folate.”

Antioxidants or Anti-H Pylori Rx May Prevent Gastric Cancer

“Or?” Previous studies have shown that the gastric acid in H. pylori infected stomachs is lower in ascorbic acid than controls. Considering that H. pylori prefers a basic environment to survive, this makes sense. Therefore, adding high levels of ascorbic acid may disrupt H. pylori, thereby lowering its potential increase risk for gastric cancer.

J Natl Cancer Inst 2000;92:1868-1869,1881-1888 In a high-risk population with precancerous gastric lesions, both anti-Helicobacter pylori therapy and antioxidant supplementation with ascorbic acid or beta-carotene appears to be effective in curing these lesions, according to findings from a randomized trial. According to the researchers, compared with placebo, all treatment protocols resulted in statistically significant rates of regression. For patients with nonmetaplastic atrophy, the relative risk of regression with anti-H pylori therapy was 4.8; for beta-carotene treatment it was 5.1 and for ascorbic acid it was 5.0, according to a report in the December 6th issue of the Journal of the National Cancer Institute. The relative risk of regression among patients with intestional metaplasia was 3.1 with anti-H pylori therapy, 3.4 for beta-carotene treatment and 3.3 for ascorbic acid therapy.

Potential Clinical and Economic Effects of Homocyst(e)ine Lowering

This study concludes that a “screen and treat” method is more cost effecting than a universal treatment strategy. A few things to consider. First, a high dose B12/folic acid supplement is very inexpensive (as low as $8/month) and has no side effects. And, getting your physician to even screen for high homocysteine levels can be like pulling teeth–sometimes just supplementing is much easier. The other, and more important factor to consider is that B12 and folic acid do not have benefits isolated to lowering homocysteine levels alone. Their therapeutic and preventative values extend to a wide range of diseases and conditions, and the cost/benefit ratio is ridiculously low when all this is taken into account. Potential Clinical and Economic Effects of Homocyst(e)ine Lowering http://archinte.ama-assn.org/cgi/content/full/160/22/3406

Delivery of Complementary Medicine Needs Improvement

This study states that many patients are unhappy about their physician’s lack of knowledge in the area of CAM therapies. I am strongly biased on this issue because I see similar analogies with the chiropractic profession. Many practioners have learned manipulative therapy in weekend “crash courses,” but the uncontested professionals and experts are chiropractic physicians. They have the training and experience to deliver manipulative procedures safely and effectively. The same is occurring with CAM therapies; physicians are learning about CAM therapies on weekend crash courses. Gathering knowledge of CAM therapies takes hours upon hours of constant learning, and unless a physician is committed to this process, they should not delve into it; it will only dilute and discouraged its effectiveness.

(article) Dec 05 – Patients who use complementary and alternative medicine (CAM) are convinced of its efficacy, but are unhappy about the costs and the lack of knowledge by their traditional physicians about CAM, according to comments made at a press conference here at the White House Commission on Complementary and Alternative Medicine Policy meeting. Dr. Gordon and others at the conference insist that CAM services are no more expensive, and in some cases less expensive, than traditional medical treatments. “The biggest barrier to obtaining reimbursement is probably skepticism on the part of traditional medicine providers,” he said. “We intend to ask the Congress to mandate education about CAM therapies as part of medical school as well as other professional programs. More education about these therapies would reduce skepticism and allow physicians and others to provide their patients with more information on ! CAM.” Education about CAM might also result in provision of such services in the same places as traditional medicine, resulting in greater convenience for the patient, Dr. Gordon said.

US Panel Unconvinced of Safety of Genetically Modified Corn

It is wonderful to hear of government-associated panels coming down on the side of safety, as opposed to financial considerations and ties. The controversy of genetically modified foods continues. I still cringe at the idea of man trying to best Mother Nature. We are going to produce brand new proteins never before seen on this planet and there is no way to predict how our bodies and the environment will react to these new proteins.

(article) An independent panel of US scientists has dealt a blow to a bid by Aventis, the giant Franco-German pharmaceutical maker and seed company, to win temporary approval of the use of StarLink genetically modified corn for human food. The group of physicians, chemists and other scientists concluded that StarLink, a type of corn engineered to repel pests, has a “medium likelihood” of causing allergic reactions. More data are needed, however, to analyze the allergenicity of StarLink’s unique Cry9C protein, the report said. The science panel’s report raised more questions about StarLink’s safety, suggesting that it may be to blame for rashes, diarrhea and other allergic reactions reported by some 44 Americans. As many as 14 of those illnesses may have been caused by StarLink, but further investigation is needed to rule out other allergens, the report said. In September, traces of StarLink were found in taco shells pur! chased at a Washington, DC-area grocery store, setting off a massive recall of more than 300 kinds of taco shells, chips, cornmeal and other foods made by US companies. Investigators determined that a portion of the 80 million bushel StarLink crop this year was accidentally commingled with vast amounts of conventional corn by farmers, grain elevators and shippers, and Aventis launched a $100 million corn buy-back program.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.







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